The following is a summary of a recent medical emergency, accompanied with an explanation of the services provided during the care of the patient. The purpose of this writing is to educate the community about the nature and quality of some of the services the Portsmouth Fire Department provides.
Care has been taken to protect the privacy of the patient; any identifying information has been omitted.
During a recent evening an individual called 911 reporting a family member was ill with shortness of breath. Captain Sousa, Lieutenant Ethier, Lieutenant Bowley, Firefighter Cabecerias, and Fire Fighter Lautieri responded in Rescue 1 and Engine1. The EMT / Firefighters arrived to find the patient had gone into cardiac arrest sometime during their 4 minute travel time.
Responders immediately initiated resuscitation procedures inside the patient’s residence (including CPR, cardiac monitoring, intravenous access, administration of medications, and the insertion of an airway). The patient’s heart was not beating and had no electrical activity. The patient was transferred to the ambulance without any interruption of the resuscitation efforts.
The ambulance began the 10 minute transport to the hospital with four EMT’s on board; one EMT drove the ambulance, one EMT maintained the patient’s airway, one EMT administered and tracked medications, and the fourth EMT ran the defibrillator and delivered CPR compressions. At some point during the transport, a reassessment of the patient was performed and a cardiac rhythm and pulse was discovered.
Although an improvement in the patient’s condition, the pulse rate was too fast and the patient was extremely unstable. To treat this life threatening situation, the EMT’s performed a procedure called cardioversion. This procedure delivers a small electrical shock to the heart at just the right moment to convert the dangerous rhythm to a more stable one. This procedure was performed three times before the EMT’s were successful in converting and maintaining a normal cardiac rhythm.
The patient arrived at the Hospital Emergency Department with a pulse and a blood pressure.
Key points to take away from the scenario:
- Firefighters responded with the proper number of people to handle the call. Any experienced firefighter will tell you the reported problem and the actual problem is very often different.
- All Portsmouth Firefighters are not only EMT’s but also provide advanced life support. Many firefighters are not EMT’s, let alone providers of advanced life support.
- Portsmouth Firefighters are well trained and these particular firefighters were able to execute their training when it mattered most.
- Advanced equipment was utilized: Autopulse – a CPR machine that provides superior CPR compressions and has been shown in studies to have a significant impact on survival rates. Two of these expensive pieces of equipment were purchased by the Portsmouth Volunteer Fire Department (no tax payer dollars). A laryngeal mask airway was used to breathe for the patient. This device was used because of its effectiveness and its ease of use. The device is more expensive than a traditional airway but its use is in the best interest of our patients. Advanced cardiac monitors / defibrillators – The department recently purchased two of these devices with donated funds. The new machines are able to simplify complicated procedures and allow our responders to provide advanced care.
Summary: Well-trained responders, operating advanced equipment and delivering aggressive procedures, saved a Portsmouth resident’s life. Portsmouth residents should take comfort knowing that this caliber of care is provided in our community. Resident’s should also realize that medical services are just a single aspect of the response capabilities of Portsmouth Fire Department.
Portsmouth responders provide fire suppression, fire prevention, and a variety of advanced technical rescue services.